Executive Function

PresenterDr. Anusa A MFirst year MD PG

Prepared by Prof. Rooban T,

Oral & Maxillofacial Pathologist

Introduction

What is Executive Function

Unified term for cognitive processes that

regulate,

control,

manage other cognitive processes such as

planning, working memory, attention, problem

solving, verbal reasoning, inhibition, mental

flexibility, task switching and initiation and

monitoring of actions.

What is Executive Function ?

Is a theorized cognitive system in psychology  that

controls and manages other cognitive processes.

Responsible for processes that are also referred to

as executive functions, executive skills, supervisory

attentional system, or cognitive control.

Definition

“The CEO of the Brain”Saltus, 2003

This description focus attention on the

increase in frontal lobe synaptic

connectivity that begins to occur during

adolescence, eventually leading to

developmental improvements in self-

direction and self-control - Stuss &

Alexander, 2000

Directive capacities of the human brain –

Goldberg, 2001

Definition

Definition

“There are specific processes related to different brain regions within the frontal lobes. There is no frontal homunculus, no unitary executive function”

- Stuss and Alexander (2000)

“Multiple executive functions that govern human conscious perceptions, feelings, thoughts, and actions as constituting a collection of “co-conductors” of an orchestra in a highly collaborative manner with the others”

Definition

The ability to

Shift from one concept to another

Modify behavior, particularly in response to new

or modified information about task demands

Synthesize and integrate isolated details into a

coherent whole

Manage multiple resources of information

Make use of relevant acquired knowledge Stuss, 1992

Definition

Ability to plan ahead and organize behavior across time and space in order to fulfill goals and intentions

The ability to shift strategies and adapt to changing circumstances

Planning, decision making, directed goal selection, and monitoring of ongoing behavior

Also involved in self-awareness, empathy, and social sensitivity

Temple, 1997

Definition

Gioia, Isquith, Guy, & Kenworthy (1996) on

defining Executive Functions:

A collection of processes or interrelated functions

responsible for

Guiding, directing, managing cognition, emotion

and behavior, particularly in novel

problem-solving situations

Purposeful, goal-directed problem-solving behavior

Definition

Denckla (2001) “Clinical Descriptors—EF Terms from Cognitive Psychology:”

Supra-ordinate (Higher Order) Processes Meta-cognitive or Metamodal Capacities Control Processes (Initiate, Sustain, Inhibit,

Shift)▪ Set Maintenance▪ Self-Monitoring and Flexibility▪ Inhibitory Processes

Integrative Processes Sequencing/Organizing Processes

Models of Executive functions

EF Models

Top-Down inhibitory control Model

Supervisory Attentional Model system – Norman & Shallice, 1986 and further expansions

Working memory Model- Baddley, 1996, 2002

Self regulatory Model

Problem solving Model

EF Models

Conceptual Model, Lezak

Neurophysiological Model, Barkley, 1997

Miller and Cohen Model, 2001

Holarchical Model – McCloskey, 2004

Miyake and Friedman’s Model

Cascade of control Model, Banich, 2009

Supervisory Attentional Model System

Norman & Shallice, 1986 –

ContentionScheduling

(3)

TriggerDataBase

Special-purposeCognitiveSubsystems (1)

PerceptualSystem

SupervisoryAttentional System (4)

SchemaControl Units

(Action)

(2)

Supervisory Attentional System

Shallice (1981)

Supervisory Attentional System

Supervisory Attentional Model System

Shallice and Burgess, 1996 – expanded further

Working Memory Model

Baddley, 1996 and 2002

Visual Semantics

Episodic LTM

Language

Neurophysiological model of Self regulation

Barkley, 1997

The McClosky Holarchical Model, 2004

Self Activation

Initiation and “ramping up” of basic

executive functions related to an awakened

state of mind and to overcoming sleep

inertia.

Self Regulation

A set of control capacities that cue and

direct functioning across the domains of

sensation/ perception, emotion, cognition,

and action

Self Realization

Directs cognitive processes that engage in self-

awareness, self-reflection and self-analysis.

Cues cognitive processes to access

accumulated information about self and apply

it in specific situations to initiate, sustain, or

alter behavior.

Self Determination

Foresight/Long-Term Planning and Goal Generation

Directs the use of cognitive processes to construct

visions of the future and plans for action over longer

periods of time.

Directs reflection on the past for purposes of

improving or altering behavior and thinking in future.

Self Generation

Pose speculative questions related to the meaning and

purpose of life and/or the ultimate source(s) of reality

and physical existence, mind-body relationships, spirit,

and soul; contemplates existence beyond the physical

plane.

Directs the generation of a philosophy of life used to

guide self-awareness, self-realization and the other levels

of executive function processes; serves as a basis for an

ultimate source of intentional behavior direction.

Trans-Self Integration

Directs the engagement of mental processes that

enable realization and experiencing of a trans-self

state of ultimate or unity consciousness.

In most spiritual traditions, this state is considered

the highest achievement of human consciousness

and therefore very different from the maladaptive

states characteristic of clinical diagnoses of

dissociative states.

IV. Self Generation

III. Self Control:

Self Determination

Goal Generation

II. Self Control: Self Regulation

Initiate

Modulate

Execute(BehaviorSyntax)

Focus Attn Sustain Attn MonitorCheck

Interrupt/Stop

Inhibit

Perceive Organize

Manipulate Store

Retrieve

I. Self Control: Self Activation

Mind-Body Integration, Sense of Spirit

Awaken, Attend

Anticipate

Hold Balance

Correct

Generate

Time Sense

Pace

V. Trans-self IntegrationSense of source, Cosmic consciousness

Sensation/Perception Cognition Emotion Action

Self RealizationSelf

AwarenessSelf

AnalysisLong-Term

Foresight/Planning

Gauge

Shift

Associate

Choose

Focus Effort Sustain EffortFlexible

Plan

Time Mgt

Cascade of Control Model

Unified concept of all existing models

Bannich et al., 2009

Three levels Neurobiological Psychological Computational

Cascade of Control Model

• Bias to task relevant process

Posterior DLPFC

Executive Function Development - Lines and Levels

EF development

Brain and EF

Arenas of Involvement for EF

Variations in types of activities affected by

EF is a key concept in understanding what

we refer to as the arenas of involvement

in which the effects of executive functions

are manifested.

4 key arenas

Arena Implication

Intrapersonal Control one’s own internal states

Interpersonal Interactions with others

Environment Interactions with the environment around them

Symbol system Engagement with the tools of the culturally derived symbol systems used to process and share information

Arena of interaction and EF

Internal command vs External demand

INTERNAL COMMAND

Executive control can stem from a person’s own internal desires, drives, aspirations, plans, and proclivities

Easier and Less effort

EXTERNAL DEMAND

Executive control summoned by sources outside of the person, executive control is being initially cued.

Tough, more effort

Domain Implication

Perception Executive control of modes of input including perception of external (sensory)and internal (representational) stimuli

Cognition Executive control of thoughts & thought processes

Emotion Executive control of feelings & emotional processes

Action Executive control of modes of output including behavior in external world and storage & retrieval of internal representations

Domains of functioning

Other Executive Function Assessment dimensions

Contextual factors

Factor Explanation Mental Stance Consciously directed vs. non

consciously convectedLocus of Intention Internally commanded vs.

externally demandedMaturation Chronological age and degree of

neural developmentBiological Constraint

Medical conditions

Contextual factors

Factor Explanation

Multi-Cueing

Capacity

Simultaneous vs. sequential ordering of

multiple EF capacities, multitasking, EF

“syntax”

Task

Constraints

Constraints on how information is

processed when performing a task

Generalizatio

n

Setting specific vs. setting nonspecific

Energy Executive control stamina fluctuations

Temporality Temporal nature of any observed stamina

fluctuations

Information processing capacities

Time frames for reference

Factor Explanation Immediate Initial registrationExtended Immediate Active working memoryRemote and recent past

Retrieval from long term store

Areas of Academic skill

Tests for EF Wisconsin Card Sorting Test

WCST; Heaton, Chelune, Talley, Kay, & Curtiss, 1993

Delis-Kaplan Executive Function System

D-KEFS; Delis, Kaplan & Kramer, 2001

NEPSY: A Developmental Neuropsychological Assessment

Korkman, Kirk, & Kemp, 1998

Behavioral Assessment of the Dysexecutive Syndrome

BADS; Wilson, Alderman, Burgess, Emslie, & Evans, 1996

Behavior Rating Inventory of Executive Function

BRIEF, BRIEF-2, BRIEF-SR; Gioia, Isquith, Guy, & Kenworthy, 2000

Frontal Systems Behavior Scale

FrSBE; Grace & Malloy, 2001.

Conditions with Executive Dysfunction

ADHD Conduct disorderDepressionBipolar disorderOCD Tourette syndromeHuntington's diseaseWilson's diseaseSchizophreniaAutismAsperger's syndromeNonverbal learning disordersTurner's syndromeFragile X syndrome

PhenylketonuriaFrontal brain tumorsTraumatic brain injuryAcquired brain injury, via toxins, anoxia, infections, etcComplex partial epilepsy of frontal originWilliams syndromeVelocardiofacial syndromeHydrocephalusFetal alcohol syndromeMetachromatic leukodystrophyCerebellar tumors

EF in AD/HD

Difficulties with the self- regulation cues of

Inhibit, Focus/Select, and Sustain.

Self-realization difficulties involving delayed

development of self-awareness, self-analysis,

long-term goal setting, and long term

foresight/planning

EF in Autism Spectrum disorder Include deficiencies related to

interpersonal arena.

Involve perception, emotion, cognition, action, difficulties with self-analysis and self-awareness

Severe deficits in self-determination

Decreased Fluency, Impaired Planning, Altered Flexibility

EF in ODD, CD

Multiple self-regulation and self realization

deficits.

Deficits are expressed in one arena of

involvement—the interpersonal arena—and

involve primarily the emotion and cognition

domains of functioning.

These difficulties are often accompanied by

difficulties with self-analysis and self-awareness

EF in Schizoprenia

Deficits include impairment in attention,

working memory and EF

Loss of verbal and visual learning and

memory, working memory, immediate,

selective and sustained attention,

perceptual/motor processing and motor

skills

EF in Schizoprenia

Amnesia, Loss of episodic memory only

Working memory and multi-tasking

impairments typically characterize the

disorder.

Deficits in response inhibition and

cognitive flexibility

EF in Parkinson’s disease

Problems with memory and thought

processes.

Increased distractibility

Problems in set formation and maintaining

and shifting attentional sets

Deficits in self-directed planning, problems

solving

EF in Parkinson’s disease

Working memory show deficits in the areas of: a) spatial working memory b) central executive aspects of

working memory c) loss of episodic memories d) locating events in time

EF in Fetal Alcohol Spectrum disorder

Decreased measures of planning ability, selective inhibition, concept formation and reasoning.

Decreased set-shifting, planning and strategy use, attention and spatial working memory, longer reaction and decision time

EF in Bipolar disorder

Problems of attentional processing, EF and verbal memory

Impairment in visual memory, working memory and risk taking behavior, selective attention, attentional shifting, verbal planning, verbal memory, perseveration

Loss of processing speed, inhibitory control, response inhibition and strategic thinking

Executive Functions

Plan actions towards a goal

Use information flexibly

Realize consequences

Draw inferences

Independent of IQ

EF and Brain

Function Capacity

Implicated Brain area

Self-Activation

Reticular activating system, epithalamus, caudate nucleus, anterior cingulate, dorsolateral cortex

Self-RegulationPerceive Prefrontal cortex, ventromedial

prefrontal, paracingulateInitiate Orbitofrontal cortex, anterior

cingulate; dorsolateral prefrontal cortex; superior medial

EF and Brain

Function Capacity

Implicated Brain area

Focus/Select Anterior cingulate; dorsolateral prefrontal cortex

Gauge Anterior cingulate, dorsolateral prefrontal cortex

Modulate Cingulate gyrus, orbitofrontal cortex, basal ganglia

Interrupt/Stop

Orbital prefrontal cortex, anterior cingulate, amygdale; right inferior frontal gyrus

EF and Brain

Function Capacity

Implicated Brain area

Inhibit Middle and interior frontal gyrus, orbitofrontal cortex, caudate, nucleus, basal ganglia, striatum; left superior frontal cortex

Sustain Dorsolateral prefrontal cortex, orbitofrontal cortex, thalamus, anterior cingulate

Hold Dorsolateral prefrontal cortex, anterior cingulate gyrus, left frontal cortex, anterior insula, frontal gyrus, cerebellum, hippocampus

EF and Brain

Function Capacity

Implicated Brain area

Manipulate Dorsolateral prefrontal cortexOrganize Dorsolateral prefrontal cortex Store Left prefrontal cortex, basal gangliaRetrieve Hippocampus, dorsolateral prefrontal

cortex, ventrolateral prefrontal cortexForesight/Plan

Dorsolateral prefrontal cortex, orbitofrontal cortex, striatum, hippocampus, cerebellum

Generate Left inferior frontal gyrus, bilateral frontal cortex and superior parietal lobes; dorsolateral prefrontal cortex; anterior cingulated

EF and Brain

Function Capacity

Implicated Brain area

Associate Left dorsolateral prefrontal cortex Balance Cerebellar-frontal pathway, anterior

cingulatedTime Orbitofrontal cortex Pace Basal ganglia, dorsolateral prefrontal

cortex; anterior cingulatedExecute Dorsolateral prefrontal cortex, interior

parietal, striatum,basal gangliaMonitor Dorsolateral prefrontal cortex,

anterior cingulate; right lateral prefrontal cortex

EF and Brain

Function Capacity

Implicated Brain area

Correct Dorsolateral prefrontal cortex, orbitofrontal cortex

Self-RealizationSelf-Awareness

Posterior cingulate or paracingulate sulcus, anterior medial and ventromedial prefrontal cortex, parietal region, left and right basal temporal regions, left orbitofrontal cortex, frontal gyrus, limbic and insula regions

EF and Brain

Function Capacity

Implicated Brain area

Self-Determination

Orbitofrontal cortex, ventromedialprefrontal cortex

Self- Generation

Medial frontal gyrus, posterior cingulate, angular gyrus, dorsolateral prefrontal cortex, anterior cingulated

Trans- Generation

Prefrontal cortex, anterior cingulate, reticular and middle thalamic region, basal ganglia, dorsolateral prefrontal cortex

Prefrontal Cortex and EF

PFC is a major area for EF to occur though other areas are involved

4 important functions involved Selective attention Working memory Preparatory set Monitoring

Perpetual Memory

Acquired through sensory organs.

@ basic level- memory of elementary sense perceptions, in sensory and parasensory cortices.

@ higher levels, multimodal sensory memories, in "trans-modal" cortex

@ higher cortex - includes episodic and semantic memories to form declarative memory.

The highest level is conceptual memory, form of perceptual knowledge.

Fuster J., 2003

Thank You

Declarative Memory

Declarative memory is conscious memory.

Knowledge of facts and events episodic (time-related data of past

experiences) semantic (fact-related) data.

Declarative memory stores information about facts (who, what, when, where) and the relationship between them.

“explicit memory” or “cognitive memory.”

Nondeclarative Memory:

That cannot be accessed consciously. Motor learning, habits, and conditioning. Includes skills achieved through repetitious

exposure Involves multiple senses , systems Utilizes multiple motor and cognitive

pathways in its execution. Other names “implicit memory,”

“dispositional memory,” or “nonconscious memory.”

Types of memory

Short term or Working Memory Long term memory - stored, permanent

information Semantic Memory - general information involving

who, what, why

Episodic Memory- information associated with time and place where memory was formed

Procedural Memory - stores information on how to do something

Perceptual Memory - serves to identify objects and structure of language; memory through senses

Short term or Working Memory Short lived; unprocessed;   3 phase - central executive, the visuo-

spatial sketchpad, and the phonological loop

Phyletic memory is a basic form of memory from primary sensory and motor cortices and foundation of individual memory

Executive memory is the representation of motor acts and behaviors